Idaho is No. 1 in the country in terms of how much flexibility patients and providers have with shaping health care, according to a report released on Friday by George Mason University.

"The Healthcare Openness and Access Project (HOAP) is a toolkit that allows each state to compare its laws, regulations and markets with those of other states," a press release issued by the university's Mercatus Center states.

"It is intended to spur conversation on what works — and doesn't work — as the country moves to improve Americans' healthcare quality, options and access."

Robert Gaboyes, one of the authors of the report, said researchers suspected Idaho would rank high in the report when the project started about a year ago, so he wasn't surprised it's No. 1.

"In many ways, Idaho, along with other Rocky Mountain states, takes a relatively hands-off approach with respect to health care," said Gaboyes, a researcher at George Mason's Mercatus Center. "The state gives patients and providers considerable leeway in deciding what sort of care is produced and how it is delivered.

"Health care today is in a remarkable period — one in which digital and other technologies allow the health care system to provide better health for more people at lower cost, year after year. A state like Idaho will likely be especially well-positioned to take advantages of these new wonders. Some, like telemedicine, can be lifesaving —especially in a state with vast rural areas."

Following Idaho high in the rankings were, in order, Montana, Missouri, Mississippi and Utah. At the bottom of the list were Rhode Island, Connecticut, New York, New Jersey and Georgia.

How Idaho ranked on the 10 equally-weighted factors that measure the control patients and providers have over broad areas of health care included:

• how much leeway providers have over management and structure of their businesses, eighth;

• how amendable the state to the direct primary care model for practices, fourth;

• insurers' flexibility to determine pricing of health insurance policies, first;

• how constrained physicians are by the threat of malpractice, eighth;

• medical professionals' access to licensure, second;

• access to experimental drugs, 19th;

• how freely hospitals compete with each other, 19th;

• access to substance abuse remedies, 19th;

• how burdensome taxes are on healthcare services, 18th; and

• allowance of telemedicine, 12th.

"States control the most intimate aspects of health care and can alter them without seeking federal government approval," Graboyes said. "The actions that states take in these areas have an enormous effect on the cost and quality of care."

Darcy Bryan, a professor at the University of California at Riverside School of Medicine, and Jared Rhoads, a researcher at The Dartmouth Institute for Health Policy and Clinical Practice, assisted Graboyes with writing the report.

Neither Rick Rasmussen, CEO of Northwest Specialty Hospital in Post Falls, nor Patt Richesin, president of the new Kootenai Care Network, could be reached for comment on Friday.

The Kootenai Care Network features about 450 local providers who collaborate on health care with the intent of improving the quality in a more efficient manner than can be achieved independently.